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Cardiothoracic Surgery

Arrhythmia Control

An estimated two million Americans live with irregular heart rhythms, called arrhythmias. NewYork-Presbyterian Hospital is a world leader in arrhythmia control, which combines the study, diagnosis, and treatment of heart rhythm disturbances in both adults and children.

Atrial fibrillation is a form of arrhythmia in which the atria (the two small upper chambers of the heart) beat chaotically. While there are a number of variations of atrial fibrillation with different causes, they all involve irregularities in the transmission of electrical impulses through the heart. As a result of these irregularities, the heart is not able to pump blood effectively, which can cause blood to pool and form clots. This situation can lead to stroke, congestive heart failure, or cardiomyopathy.

At NewYork-Presbyterian, we offer our patients a range of treatment options for severe arrhythmias, including medication, pacemakers and defibrillators, non-surgical ablative techniques, and surgical approaches — such as the modified Maze surgical procedure which interrupts the path of electrical impulses that cause the arrhythmia.

The Maze procedure is designed to cure atrial fibrillation, an arrhythmia of the upper chambers of the heart, by interrupting the electrical impulses that cause the abnormal rhythm. This open-heart surgery involves the placement of incisions in both atria. When the incisions heal, scar tissue forms forming a "roadblock" that prevents the abnormal electrical impulses from passing through the heart. In so doing, it corrects all the major problems associated with atrial fibrillation: it stops the atrial arrhythmia, it restores normal rhythm between the atria and the ventricles, and it preserves the ability of the atria to contract on its own.

In the modified left atrial Maze procedure, the area around the pulmonary veins — thought to be the site where irregularities in the electrical impulses form — is treated with either freezing temperatures (cryoablation), or with a heat source, such as radiofrequency, microwave, or laser energy. This treatment forms a barrier that disrupts the pathway of abnormal electrical impulses, thereby curing the arrhythmia. Based on our success rate of up to 90%, we now offer a modified left atrial Maze procedure to all patients with atrial fibrillation who are having a concurrent open-heart procedure.

Physicians at NewYork-Presbyterian have been pioneers in the area of minimally invasive atrial fibrillation surgery. Our surgeons have also developed a totally closed chest, robotically assisted, beating heart operation for atrial fibrillation. Patients having this procedure are discharged within a few days, with only puncture-sized incisions in the chest.